All student-athletes benefit regularly from the care of an athletic trainer, and most receive good counsel on gaining strength, improving conditioning and healing from injuries.
Now, an increasing number of student-athletes are learning from experts about how eating right is a key to achieving those goals — and more.

Athletics programs appear to be turning to experts on nutrition — and increasingly, to certified sports dieticians — not only to deal with eating problems, but ultimately to improve both the health and performance of student-athletes.

Just a decade ago, only a handful of NCAA institutions’ athletics departments employed nutritionists or dieticians. Now, that number is growing, in part because of efforts by a few veteran sports dieticians to promote the benefits of good nutrition not only for student-athletes, but also as part of institutions’ broader sports medicine efforts.

“It’s been developing steadily over the last five or six years,” said Ingrid Skoog, director of sports nutrition at Oregon State University, who administers a listserv for collegiate sports dieticians and has been collecting information from nutritionists and dieticians in athletics programs.

She’s seeing a trend not only toward hiring certified sports dieticians — individuals who have received a CSSD credential (Certification as a Specialist in Sports Dietetics) from the Commission on Dietetic Registration — but also establishing them as full-time members of sports medicine teams in athletics departments.

“Nutrition has sort of been covered by the athletic trainer or by strength and conditioning,” she said. “But as things evolved and their jobs got more complex, and sports nutrition became more valued, then there started to be spaces for sports nutritionists on staffs. I’d say that started to surge probably around 2002.”

Why are those trends developing? Mary Wilfert, NCAA associate director of education services, suggests that member institutions increasingly are seeing nutrition not only as the key to keeping student-athletes healthy, but also achieving peak athletic performance.

“We know how important nutrition is at many levels,” Wilfert said. “We know how important it is for academic performance. It is one of the foundations of personal health. And it is very important for athletic performance, in a lot of ways — for improving performance, and reducing and recovering from injury. Those are things where nutrition is foundational.”

Skoog said improving performance is the ultimate objective of collegiate sports dieticians.
“All of us ultimately want to help the athlete achieve peak performance,” she said. “I lead off my talks (with Oregon State athletics teams) by saying, ‘You’re not going to reach your athletic potential unless you have a nutrition strategy to go along with your training and performance strategy. That’s probably the central message.”

The messengers

Who’s delivering that message? The growing ranks of sports dieticians include:

A former Division I collegiate gymnast who operates what Skoog describes as a model program at Virginia Polytechnic Institute and State University for integrating nutrition into sports medicine.
A nutritional consultant whose work with running groups and high school programs attracted the interest of a Texas A&M University, College Station, athletics department that was relying on athletic trainers and strength and conditioning coaches to oversee nutritional needs.

A former 135-pound student in nutritional science and dietetics at the University of Nebraska, Lincoln, who wanted to help football players gain the weight he was unable to put on to succeed in athletics, and eventually became director of sports nutrition programs at his alma mater and the University of Oregon.

All have seen the programs they direct evolve from dealing with problem cases — student-athletes who weigh too little or suffer eating disorders — into comprehensive initiatives to educate student-athletes about how to make healthy choices about food while addressing such issues as managing diseases like diabetes or using dietary supplements.

“The things I try to address are how to gain weight appropriately, how to lose weight appropriately and healthily, and making sure you’re fueling and refueling so we can reduce the chances of an injury,” said Amy Freel, a former gymnast at Ball State University who became Virginia Tech’s first full-time director of sports nutrition in 2002.

“We look at body composition to make sure that each individual is finding a zone that is appropriate for them. Another huge component is looking at sport psychology with disordered eating, working with the athletic trainers for pregame and postgame meals, and also overall medical concerns — anemia, stress fractures, any type of diabetes, high blood pressure or anything that would be just a typical medical issue.”

Freel has been able to put the interdisciplinary component into practice with the creation of a nutrition and performance committee at Virginia Tech that includes a team physician, sports psychologist, strength and conditioning coach, and athletic trainer. The team regularly discusses ways to enhance performance and address disordered eating.

“As a professional, it is a tremendous resource to have my sports psychologist or have my team physician,” she said. “Not only do we use each other’s knowledge, but we can also bounce ideas off of each other and come up with a different approach that works with an individual.

“As far as our goals, they’re just to successfully work with each individual and with each individual team in creating and improving their performance. It’s easiest, we’ve found, to do that as a team. So many other issues come out. I might be working with an athlete and, all of a sudden, issues come out like they’re depressed or they’re homesick. Well, I can now address that by getting them with our full-time sports psychologist.”

Texas A&M hired Amy Bragg in 2004 as its first director of performance nutrition after the head of the school’s athletic training staff approached new Athletics Director Bill Byrne seeking help for his staff in dealing with nutrition issues.

“One of our former head coaches here felt like one of the untapped areas of trying to deal with and maintain performance levels was the area of nutrition,” said Karl Kapchinski, assistant director of athletics for athletic training at the school. “We felt we needed to get somebody in here and try to tap that area, to help enhance the education and help enhance our menus we were providing for these kids. By doing that, we felt we could also help these kids perform and be the best they could from a nutritional aspect.”
“What I wanted to do was to make nutrition more of a systems approach,” Bragg said. “What people expected of me when I walked in the door was, ‘Hey, we’ve got some overweight guys, and we want you to fix them.’ Well, that makes going to the nutritionist very punitive. I wanted to eliminate and to change that.”

Like Freel was doing at Virginia Tech, Bragg quickly began implementing a range of both one-on-one and team educational programs, took charge of body composition testing, and developed relationships with other sports medicine personnel — all steps that ultimately helped Bragg win the confidence of Texas A&M’s student-athletes.

“At this point, I’m just another part of the program,” she said. “I travel with everybody at some point. I travel with football a ton. And they just get used to you. You’re part of the team. So you have a strength coach, you have a nutrition person, you have a team doctor, etc. — it’s just another part of the team.”

Freel and Bragg are relative newcomers to the profession compared to James Harris, the Nebraska undergraduate student who volunteered in 1997 to help with the blossoming sports nutrition program at the school, then served as its director from 2002 (when Byrne selected him before departing for Texas A&M) until accepting an offer last year to succeed Skoog as director at Oregon.

“It’s evolved,” Harris says about collegiate sports nutrition programs around the country. “Of course, when a dietician first gets on campus, the problems will stick out…but once you get through those people, you can be more proactive in trying to improve performance, and applying some of the science out there toward being a better athlete. Once you get to that point, that becomes the focus — that becomes your main job. And then that eliminates some of the problems.”

Like Bragg, Harris credits Byrne for understanding the key role nutrition plays in student-athletes’ success, and for the potential of sports dieticians to accomplish more than solving eating problems.
“He saw a need for those things to be incorporated into an athlete’s daily life,” Harris said.

 “Otherwise, it would be almost like having a trainer only after an athlete got hurt: ‘OK, you got hurt, now you need to see a trainer,’ as opposed to having a trainer around ahead of time to work on some things to stop people from getting hurt.”

Networking and certification

Naturally, as more athletics departments hire nutrition experts, those professionals also are enjoying the benefit of becoming part of each other’s professional life.

“One thing that happened was, around 2002 or 2003, a group of three of us got together and said, ‘Wow, we should try to find a way to talk to each other,’” said Skoog, who at the time was working as Oregon’s director of sports nutrition. “So we developed a listserv, and that helped us identify people out there — we didn’t know who was doing what and where.”

Skoog said there currently are about 70 listserv members serving in collegiate sports nutrition positions.

“We’ve been able to talk about regulations, legislation and application to different institutions. We’ve really, just as the NCAA tries to level the playing field, been able to do that also through sport nutrition working as a group, because we can understand each others’ perspective.”

Those conversations also are fueling efforts to formally establish a specialized collegiate interest group affiliated with Sports, Cardiovascular and Wellness Nutritionists (SCAN), a group of practicing dieticians within the American Dietetic Association.

“We’re trying to accomplish some of our goals having to do with educating, promoting and collaborating, and forming a leadership group to discuss that,” Skoog said.

Among the group’s goals is to encourage athletics programs to seek registered dieticians to serve student-athletes, and preferably sports dieticians with the CSSD credential.

“There are about 159 (dieticians) right now in the country who have passed the certification exam, and it’s continuing to grow,” Skoog said. “The (registered dietician) credential is a great foundation, but the perception of that is too broad. (The CSSD) allows that perception to be specialized.”
“If you have somebody who’s certified, degreed, a specialist in that area, you have a comprehensive program,” Texas A&M’s Bragg said. “You have somebody who has the ability to see diabetic athletes, work with weight-management athletes, and also address your meals and your travel plans, and what you’re going to do for fueling before competition. You have got somebody who can do top to bottom; an expert.”

Wilfert said NCAA staff members assigned to oversee health and safety issues are trying to support the group’s efforts. She and David Klossner, NCAA associate director of education services, will attend the group’s conference next spring, and the staff has distributed a flyer at various educational conferences promoting the merits of incorporating certified sports dieticians into athletics programs.

Ultimately, Wilfert thinks, supporting the growth of sports dietetics as a valued discipline in intercollegiate athletics serves the Association’s mission of promoting the health and safety of student-athletes.

“They obviously, if they are working with athletes, have the orientation and understanding — the cultural competency — to understand what the life of a collegiate student-athlete is like,” she said. “They may have to work around some things. or integrate conditioning or practice factors. It’s the cultural competency, even beyond the science of sports nutrition, that helps them better treat student-athletes.”

Skoog appreciates the support, and hopes it will provide additional momentum toward encouraging schools to focus on nutrition as part of their sports medicine efforts.

“I’d like to see schools or organizations call us up and say, ‘We’d like to hire a sports dietician. What should we be looking for?’ We’re doing that from the other side for dieticians who are moving into the field of sports dietetics. My goal, and I think the collegiate group would agree, is we really want to make sure there is a support system for those who practice in the field, and that there is a way of educating people about how we can help them.”